Factors influencing outcomes of older children with medulloblastoma over 15 years in Peru, a resource-limited setting.
Pediatr Blood Cancer
; 69(10): e29770, 2022 10.
Article
em En
| MEDLINE
| ID: mdl-35593532
ABSTRACT
BACKGROUND:
Medulloblastoma is the most common malignant brain tumor in children. While survival has improved in high-income countries (HIC), the outcomes for patients in low-to-middle-income countries (LMIC) are unclear. Therefore, we sought to determine the survival of children with medulloblastoma at the Instituto Nacional de Enfermedades Neoplasicas (INEN) between 1997 and 2013 in Peru.METHODS:
Between 1997 and 2013, data from 103 children older than 3 years with medulloblastoma were analyzed. Fourteen patients were excluded. The patients were split into two distinct cohorts, 1997-2008 and 2009-2013, corresponding with chemotherapy regimen changes. Event-free (EFS) and overall survival (OS) were calculated using the Kaplan-Meier method, whereas prognostic factors were determined by univariate analysis (log-rank test).RESULTS:
Eighty-nine patients were included; median age was 8.1 years (range 3-13.9 years). The 5-year OS was 62% (95% CI 53%-74%), while EFS was 57% (95% CI 48%-69%). The variables adversely affecting survival were anaplastic histology (compared to desmoplastic; OS HR = 3.4, p = .03), metastasis (OS HR = 3.5, p = .01; EFS HR = 4.3, p = .004), delay in radiation therapy of 31-60 days (compared to ≤30 days; EFS HR = 2.1, p = .04), and treatment 2009-2013 cohort (OS HR = 2.2, p = .02; EFS HR = 2.0, p = .03).CONCLUSIONS:
Outcomes for medulloblastoma at INEN were low compared with HIC. Anaplastic subtype, metastasis at diagnosis, delay in radiation therapy, and treatment in the period 2009-2013 negatively affected the outcomes in our study. Multidisciplinary teamwork, timely delivery of treatment, and partnerships with loco-regional groups and colleagues in HIC is likely beneficial.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Encefálicas
/
Neoplasias Cerebelares
/
Meduloblastoma
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Child
/
Child, preschool
/
Humans
País/Região como assunto:
America do sul
/
Peru
Idioma:
En
Revista:
Pediatr Blood Cancer
Assunto da revista:
HEMATOLOGIA
/
NEOPLASIAS
/
PEDIATRIA
Ano de publicação:
2022
Tipo de documento:
Article